Sepsis Flashcards
List the different types of organism which can trigger sepsis (1)
Bacteria gram positive and negative
Viruses like – herpes, hiv
Fungi
parasites
Why is the obstetric population considered high risk for sepsis? (3)
Shorter uretha
Bladder is reducded due to gravid uterus
Small amount of uring passed frequently
High Wcc masks early signs of infection
Harder to flush out uring from uretha
Invasive procedures
Weaker immune system
What is meant by the term ‘source control’ in perioperative care? Give examples which show your understanding of the term. (2)
Source control in preoperative care is when you perform an intervention to target an infection at its source (getting to the root of the problem) to try to stop it from progressing further.
For example drainage of an abscesses or debridement of infective and necrotic tissue
Outline the Sepsis Six management care bundle including actions to take as a registered perioperative practitioner, the rationale and any additional action(s) you would take. (6)
Inform a SENIOR CLINICIAN and call for help
Get IV access
Give OXYGEN if O2 saturations are low
Give IV FLUIDS –crystalloids to improve tissue perfusion and help intravascular volume and stop the chance of septic shock.
Give IV ANTIBIOTICS- Give board spectrum antibiotics AFTER the blood culture has been taken.
Take BLOOD CULTURES – Collect blood to identify pathogens and start antibiotic therapy. However, broad spectrum antibiotics will be started in the meantime whilst waiting for the results
Take URINE OUTPUT AND MONITOR – measure and monitor urine using catheter and chart this is done to asses renal perfusion and detect kidney injury
Take – LACTATE via VBG or ABG
Monitor NEWS score
Why is a rising respiratory rate an early sign that a sepsis patient is deteriorating? (2)
The lung is involved early in the inflammatory process and therefore a raised respiratory rate is often the first sign that a patient is deteriorating.
Fluids and proteins leak into the interstitial tissues causing swelling and decreased oxygen transfer
across the alveoli. This means that the respiratory rate will increase to compensate before a drop in SpO2 is seen
Why is urine output a better guide to circulation than measuring blood pressure in sepsis? (3)
Urine output will fall before blood pressure falls so this is an earlier warning that the circulation is failing. if the urine output falls, it’s likely that cardiac output has also fallen and urgent action is required.
Why do serum lactate levels rise in Sepsis and what are the implications of this? (3)
Lactate is a marker of anaerobic respiration It becomes elevated when oxygen delivery is inadequate for oxygen demand, which is known as ischaemia.
Rising serial lactate levels are
associated with poor outcomes. If lactate remains high (more than 4) after giving oxygen this is very concerning and will require urgent critical care involvement.
